J Emerg Nurs. 2020 Jul;46(4):527-538. doi: 10.1016/j.jen.2020.02.018. Epub 2020 Apr 18.
Pulmonary embolism has extremely varied clinical presentations and can be difficult to diagnose. Clinical decision rules can help determine the probability of pulmonary embolism by assessment of the clinical presentation. After the diagnosis, several prognostic rules can be used to risk-stratify and facilitate outpatient treatment of pulmonary embolism. This review addresses the utility of clinical decision rules, biomarkers in the diagnosis of pulmonary emoblism, high-risk patient phenotypes, the use of this data to make disposition decisions for patients with a diagnosis of PE, and recent shifts in the management of pulmonary embolism in the clinical setting.
肺栓塞的临床表现极其多样，诊断较为困难。临床决策规则可以通过评估临床表现来帮助确定肺栓塞的可能性。诊断后，可以使用几种预后规则来对肺栓塞进行风险分层，以便于门诊治疗。本综述探讨了临床决策规则、生物标志物在肺栓塞诊断中的应用、高危患者表型、这些数据在为确诊为 PE 的患者做出处置决策中的应用，以及临床实践中肺栓塞管理的最新变化。
